Periradicular tissue necrosis caused by accidentally injected sodium hypochlorite through fausse route in upper maxillary canine

Sodium hypochlorite (NaOCl) is a strong antiseptic agent that is usually used as endodontic irrigant for dissolving organic parts of pulp and dentin and neutralizing toxic products. However, the use of sodium hypochlorite may cause destruction of blood vessels, soft tissues and bone necrosis if extruded into the periapical region. Urgent treatment of the NaOCl accident should be oriented on pain relief, infection control and recovery. This paper shows a case of periradicular tissue necrosis after accidental extrusion on NaOCl through fausse route of right maxillary canine, and complete tissue regeneration after surgical debridement and bone augmentation with addition of platelet rich fibrin (PRF) that occurred in a 53-year old patient at the dental clinic of Faculty of Dentistry in Pancevo.

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Platelet-Rich Fibrin Promotes Periodontal Regeneration and Enhances Alveolar Bone Augmentation

BioMed Research International ◽

10.1155/2013/638043 ◽

2013 ◽

Vol 2013 ◽

pp. 1-13 ◽

Cited By ~ 20

Author(s):

Qi Li ◽

Shuang Pan ◽

Smit J. Dangaria ◽

Gokul Gopinathan ◽

Antonia Kolokythas ◽

...

Keyword(s):

Tissue Regeneration ◽

Alveolar Bone ◽

Periodontal Regeneration ◽

Principal Component ◽

Nodule Formation ◽

Bone Augmentation ◽

Pilot Studies ◽

Platelet Rich Fibrin ◽

Lineage Differentiation ◽

Osteogenic Lineage

In the present study we have determined the suitability of platelet-rich fibrin (PRF) as a complex scaffold for periodontal tissue regeneration. Replacing PRF with its major component fibrin increased mineralization in alveolar bone progenitors when compared to periodontal progenitors, suggesting that fibrin played a substantial role in PRF-induced osteogenic lineage differentiation. Moreover, there was a 3.6-fold increase in the early osteoblast transcription factor RUNX2 and a 3.1-fold reduction of the mineralization inhibitor MGP as a result of PRF application in alveolar bone progenitors, a trend not observed in periodontal progenitors. Subcutaneous implantation studies revealed that PRF readily integrated with surrounding tissues and was partially replaced with collagen fibers 2 weeks after implantation. Finally, clinical pilot studies in human patients documented an approximately 5 mm elevation of alveolar bone height in tandem with oral mucosal wound healing. Together, these studies suggest that PRF enhances osteogenic lineage differentiation of alveolar bone progenitors more than of periodontal progenitors by augmenting osteoblast differentiation, RUNX2 expression, and mineralized nodule formation via its principal component fibrin. They also document that PRF functions as a complex regenerative scaffold promoting both tissue-specific alveolar bone augmentation and surrounding periodontal soft tissue regeneration via progenitor-specific mechanisms.

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Low-Level Laser Therapy as a Coadjuvant in Sodium Hypochlorite Extrusion Management

Journal of Dentistry and Oral Sciences ◽

10.37191/mapsci-2582-3736-2(1)-023 ◽

2020 ◽

Author(s):

Diana Ened Rodríguez Zaragoza

Keyword(s):

Laser Therapy ◽

Sodium Hypochlorite ◽

Conventional Treatment ◽

Soft Tissues ◽

Treatment Protocol ◽

Low Level Laser Therapy ◽

Low Level ◽

Low Level Laser ◽

Level Laser ◽

Severe Tissue

Aim: The extrusion of sodium hypochlorite through the apical foramen is an accident that can occur during the endodontic treatment although is relatively uncommon, Due to the severe tissue damage that is caused by the solution, the management becomes important to prevent serious sequalae. Low-level laser therapy might be useful to treat damaged soft tissues because of its bio modulatory effects, which may reduce edema and prevent infection. Methods: In this clinical case, the accidental leakage of 5% sodium hypochlorite during the preparation of the root canal of an upper left canine is reported. The accident caused immediate and intense pain and severe edema and ecchymosis. The conventional treatment protocol was applied along with low-level laser therapy. Results: Clinical examination revealed the healing of soft tissue in thirteen days, besides a significant pain reduction in three days after laser therapy was applied. Conclusion: The combination of low-level laser therapy with a conventional treatment protocol could be a useful tool to manage such an accident.

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Mandibular Bone and Soft Tissues Necrosis Caused by an Arsenical Endodontic Preparation Treated with Piezoelectric Device

Case Reports in Dentistry ◽

10.1155/2013/723753 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

A. Giudice ◽

M. G. Cristofaro ◽

I. Barca ◽

D. Novembre ◽

M. Giudice

Keyword(s):

Soft Tissues ◽

Mandibular Bone ◽

Bone Necrosis ◽

Second Molar ◽

Piezoelectric Device ◽

The Right

This paper describes a case of wide mandibular bone necrosis associated with significant soft tissues injury after using an arsenical endodontic preparation in the right lower second molar for endodontic purpose. Authors debate about the hazardous effects of the arsenic paste and the usefulness of piezosurgery for treatment of this drug related bone necrosis.

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Surgical Management of Horizontal Root Fracture with Platelet Rich Fibrin (PRF) Placement: Case Report of Two Cases

Dental Journal of Advance Studies ◽

10.1055/s-0038-1671967 ◽

2013 ◽

Vol 01 (02) ◽

pp. 125-128

Author(s):

Parul Bansal ◽

Kalpana Kanyal ◽

Vineeta Nikhil

Keyword(s):

Case Report ◽

Tissue Regeneration ◽

Surgical Approach ◽

Permanent Teeth ◽

Periodontal Tissue ◽

Root Fracture ◽

Platelet Rich Fibrin ◽

Periodontal Tissue Regeneration ◽

Root Fractures ◽

Horizontal Root Fracture

AbstractRadicular fractures in permanent teeth are uncommon injuries among dental traumas, being only 0.5 - 7% of the cases. Horizontal root fractures can be managed endodontically or combined endodontic and surgical approach. Treatment varies according to the displacement and vitality of the fragments. This paper presents a case report of two cases of horizontal root fracture, present between the middle and apical third of central incisors, which were managed by combined endodontic and surgical approach, while in second case it was followed by PRF placement to facilitate osteoinduction and periodontal tissue regeneration.

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Advanced Platelet-Rich Fibrin: A New Concept for Cell-Based Tissue Engineering by Means of Inflammatory Cells

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-14-00138 ◽

2014 ◽

Vol 40 (6) ◽

pp. 679-689 ◽

Cited By ~ 161

Author(s):

Shahram Ghanaati ◽

Patrick Booms ◽

Anna Orlowska ◽

Alica Kubesch ◽

Jonas Lorenz ◽

...

Keyword(s):

Tissue Engineering ◽

Stem Cells ◽

B Lymphocytes ◽

Tissue Regeneration ◽

Distal Part ◽

T And B Lymphocytes ◽

Cell Detection ◽

Neutrophilic Granulocytes ◽

Platelet Rich Fibrin ◽

Study Protocols

Choukroun's platelet-rich fibrin (PRF) is obtained from blood without adding anticoagulants. In this study, protocols for standard platelet-rich fibrin (S-PRF) (2700 rpm, 12 minutes) and advanced platelet-rich fibrin (A-PRF) (1500 rpm, 14 minutes) were compared to establish by histological cell detection and histomorphometrical measurement of cell distribution the effects of the centrifugal force (speed and time) on the distribution of cells relevant for wound healing and tissue regeneration. Immunohistochemistry for monocytes, T and B -lymphocytes, neutrophilic granulocytes, CD34-positive stem cells, and platelets was performed on clots produced from four different human donors. Platelets were detected throughout the clot in both groups, although in the A-PRF group, more platelets were found in the distal part, away from the buffy coat (BC). T- and B-lymphocytes, stem cells, and monocytes were detected in the surroundings of the BC in both groups. Decreasing the rpm while increasing the centrifugation time in the A-PRF group gave an enhanced presence of neutrophilic granulocytes in the distal part of the clot. In the S-PRF group, neutrophils were found mostly at the red blood cell (RBC)-BC interface. Neutrophilic granulocytes contribute to monocyte differentiation into macrophages. Accordingly, a higher presence of these cells might be able to influence the differentiation of host macrophages and macrophages within the clot after implantation. Thus, A-PRF might influence bone and soft tissue regeneration, especially through the presence of monocytes/macrophages and their growth factors. The relevance and feasibility of this tissue-engineering concept have to be proven through in vivo studies.

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Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: A Narrative Review

Pharmaceuticals ◽

10.3390/ph14101041 ◽

2021 ◽

Vol 14 (10) ◽

pp. 1041

Author(s):

Agata Zoltowska ◽

Katarzyna Machut ◽

Elzbieta Pawlowska ◽

Marcin Derwich

Keyword(s):

Growth Factors ◽

Tissue Regeneration ◽

Adult Patients ◽

Application Site ◽

Platelet Concentrates ◽

Platelet Rich Fibrin ◽

Periapical Lesions ◽

Pubmed Database ◽

Proliferation And Differentiation ◽

Different Types

Platelet concentrates have been widely used in regenerative medicine, including endodontics. The aim of this manuscript was to assess critically the efficacy of PRF in the treatment of endodontic periapical lesions in adult patients on the basis of the literature. The PICO approach was used to properly develop literature search strategies. The PubMed database was analyzed with the keywords: “((PRP) OR (PRF) OR (PRGF) OR (CGF)) AND (endodontic) AND ((treatment) OR (therapy))”. After screening of 155 results, 14 articles were included in this review. Different types of platelet concentrates are able to stimulate the processes of proliferation and differentiation of mesenchymal stem cells. Platelet rich fibrin (PRF) releases growth factors for at least 7 days at the application site. Growth factors and released cytokines stimulate the activity of osteoblasts. Moreover, the release of growth factors accelerates tissue regeneration by increasing the migration of fibroblasts. It was not possible to assess the efficacy of PRF supplementation in the treatment of endodontic periapical lesions in permanent, mature teeth with closed apexes, due to the lack of well-designed scientific research. Further studies are needed to analyze the effect of PRF on the healing processes in the periapical region.

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Current approach to bone augmentation with allogeneic cortical graft: A case report

International Dental Research ◽

10.5577/intdentres.2021.vol11.suppl1.44 ◽

2021 ◽

Vol 11 (Suppl. 1) ◽

pp. 299-302

Author(s):

Utku Nezih Yılmaz ◽

Fatma Eriş Derkuş

Keyword(s):

Case Report ◽

Dental Implant ◽

Soft Tissues ◽

Alveolar Bone ◽

Healing Process ◽

Bone Defects ◽

Current Approach ◽

Autogenous Bone ◽

Bone Augmentation ◽

Alveolar Crest

Aim: Today, dental implant applications have become the most preferred option in the treatment of tooth deficiencies. Long-term successful results in dental implant applications depend largely on the volume and quality of the hard and soft tissues in the relevant region. Insufficient soft tissues and alveolar crest resorption complicate implant applications. Grafts and additional surgical procedures are required to compensate for resorption and to provide bone augmentation. Shell technique, one of the augmentation methods used in the treatment of alveolar bone defects, is an important procedure for guided bone regeneration. The purpose of this case report is to describe the treatment of vertical and horizontal bone loss with the Shell technique using allogeneic cortical grafts. Methodology: A 58-year-old female patient without any systemic disease was admitted to our clinic with the complaint of tooth loss in the right posterior mandibular region. In the intraoral and radiological examinations, it was determined that the bone volume in the relevant region was not sufficient for dental implant. Two-stage surgical treatment was planned for the patient. First, vertical and horizontal bone defects were augmented with allogeneic cortical graft application under local anesthesia. After the healing process, dental implants were placed in the sufficient volume of the alveolar bone and the patient's treatment was completed. Conclusion: Allogeneic grafts in the treatment of alveolar crest defects; it is a good alternative to autogenous bone grafts,there is no need for a second surgical field and the resulting reduction in morbidity. How to cite this article: Eriş Derkuş F, Yılmaz UN. Current approach to bone augmentation with allogeneic cortical graft: A case report. Int Dent Res 2021;11(Suppl.1):299-302. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.44 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

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Fibrina rica em plaquetas para preservação alveolar, aumento ósseo e elevação do seio maxilar / Platelet-rich fibrin for alveolar preservation, bone augmentation and maxillary sinus elevation

Brazilian Journal of Development ◽

10.34117/bjdv7n11-543 ◽

2021 ◽

Vol 7 (11) ◽

pp. 109674-109690

Author(s):

Marcia Cristina Dias Souza ◽

Gabriela Moraes Machado ◽

Rafaela Hartmann Kasper ◽

Praxedes Edmundo Machado Souza ◽

Vanessa Rossi

Keyword(s):

Maxillary Sinus ◽

Bone Augmentation ◽

Platelet Rich Fibrin

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Clinical and Histologic Evaluation of Using Block Xenograft Combined With Leukocyte-Platelet Rich Fibrin (L-PRF) Versus Intraoral Autogenous Bone Block Graft With L-PRF in Treating Localized Ridge Defects: A Randomized Clinical Trial

Perio J ◽

10.26810/perioj.2021.a2 ◽

2021 ◽

Vol 5 (1) ◽

pp. 11-21

Author(s):

Ahmed Y. Gamal ◽

Shahinaz G. Elashiry ◽

Fatma H. Eldemerdash ◽

Omar M. Elnashar

Keyword(s):

Alveolar Bone ◽

Autogenous Bone ◽

Bone Block ◽

Bone Augmentation ◽

Class Iii ◽

Platelet Rich Fibrin ◽

Oral Implants ◽

Histologic Evaluation

Background: Augmentation of vertical bone defects remains the corner stone in periodontal tissue engineering. The amount and quality of alveolar bone available in all dimensions affects the success of dental implants for restoration of edentulous areas. Adequate and healthy bone supports the degree of osseointegration which in turn affects the long-term success of oral implants. The primary aim of the study was to histologically evaluate autogenous block grafts versus synthetic block grafts for the treatment of atrophic vertical and horizontal bony defects (Siebert Class III) in the anterior esthetic zone of the mouth. The secondary aim was to clinically and radiographically evaluate the outcomes of the procedure. Methods: This was a randomized controlled clinical study with a statistically determined sample size of 10 patients per group and a total of 20 patients in both groups. Patients with vertical and horizontal bone loss were enrolled from the Department of Oral Medicine, Periodontology, and Oral Diagnosis of Ain Shams University and Misr International University. Bone augmentation procedures were performed using two techniques: autogenous bone block graft and xenograft bone block graft both with leukocyte-platelet rich fibrin (L-PRF). Results: Both autogenous and xenograft blocks in conjunction with L-PRF had a significant effect on vertical bone augmentation in cases of atrophic ridges in the esthetic region. Conclusion: Both autogenous and xenograft bone blocks in conjunction with L-PRF have a significant effect on vertical bone augmentation in cases of atrophic ridges in the esthetic region.

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